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Risk Adjustment Software

Close diagnosis gaps with precise member condition documentation and ensure accurate reimbursement.

RISK ADJUSTMENT SOFTWARE

Improve Documentation & Be Audit-Ready

The stakes are high for risk adjustment professionals as their members' health status can significantly impact risk scores and reimbursement. With smarter, faster, and more efficient risk adjustment software, you can enhance your risk score accuracy and simplify regulatory submissions.

Inovalon’s risk adjustment software helps your team close diagnosis gaps, prioritize member needs, and offer a clearer view of your data. Real-time analytics offer complete program transparency across your initiatives, driving faster and more accurate risk gap identification.

When it’s time to submit, enjoy a headache-free experience during the final mile – all while reducing member abrasion, increasing satisfaction, and improving care outcomes.

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Converged Risk

Take charge of your risk adjustment programs with complete control and no hidden surprises, all while leaving the fear of audits in the rear-view mirror.

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Converged Outreach

See all your intervention activities and vendors together in one place to ensure members get the right interaction at the right time.

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A computer monitor displays a web-based application titled Comprehensive Patient Assessment, showing patient information, assessment tabs, and a checklist of functional needs and physical assessment options.

Converged Patient Assessment

Help providers improve risk score accuracy without disturbing their day job by providing detailed documentation that helps identify, confirm, and close quality and risk gaps.

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Converged Record Review

Allow your medical record reviews to do their job faster and easier, while ensuring your plan is properly reimbursed for managed conditions and avoiding compliance risks.

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15

Of the top 15 U.S. health plans use Inovalon solutions¹

94%

YOY customer satisfaction rate²

25

Years of NCQA HEDIS^®measure certification ³

19

Years selected as an NQCA beta tester ⁴

3

Average amount of quality or risk gaps addressed/closed per intervention⁵

Products

Improve risk score accuracy, operational transparency, member outcomes, and economic performance with a comprehensive suite of risk adjustment software solutions.

Converged Risk

Take charge of your risk adjustment program and leave audit worries in the rear-view mirror with this risk score accuracy software.

Converged Risk Surveillance Analytics

Gain a better line of sight into your risk adjustment programs and stay audit ready as the regulatory landscape changes.

Converged Patient Assessment

Help provider partners improve your health plan's risk score accuracy without disrupting their day job, with this point-of-care solution for clinical documentation.

Inovalon Healthcare Data Lake

Gain a single source of truth to store, enrich, and analyze your data.

Electronic Record On Demand

Cut the complexity out of medical record retrieval by accessing records rapidly, securely, and cost-effectively.

Converged Submissions

Eliminate the headache from the last mile of risk adjustment data and encounter submissions, and deliver complete, accurate, and secure submissions - on time.

¹ Top 15 health plans based on AIS List of Top U.S. Payers, June 2025. Inovalon internal reporting based on Q1 2025 enrollment data, July 2025.
² Based on Inovalon’s 2024 Annual Customer Survey results. September 2024.
³"Inovalon’s Converged Quality Achieves 25th Consecutive NCQA HEDIS® Certification," Inovalon, July 31, 2025, https://www.inovalon.com/news/inovalons-converged-quality-achieves-25th-consecutive-ncqa-hedis-measure-certification/
⁴ Inovalon internal reporting, December 2022.
⁵ Based on Inovalon’s analysis of gap closure improvements driven by a combination of Converged Risk, Converged Quality, and Converged Outreach.

TESTIMONIALS

See What Customers Have Said

Discover the power of our risk adjustment software, from real-life users.

“

My experience has been whenever any help is needed, Inovalon is right there. We can be completely transparent and clearly open and ask anything, and Inovalon has been open to asking questions and conversations. So, Inovalon offers concierge-type of care. I think Inovalon pairs the relationship with the technology well, and it aligns with us.
Tony GraboskiAccount Manager, Geisinger Health Plan